GLASGOW SPORTS A PATIENT SURGERY SERVICE...

Gil l ian Parker Student Physiotherapist

Frank Gilroy BSc MSCP

Senthil Kumar Orthopaedic Foot and Ankle Surgeon

A PATIENT

GUIDE TO

CALF INJURY

REHABILITATION

GLASGOW

SPORTS

SURGERY

SERVICE

CONTENTS PAGE

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Written and produced by G. Parker, F. Gilroy, S. Kumar for the GSSS

Contents

Anatomy of the calf muscle

How do you injure your calf muscle?

What are the symptoms and how is it diagnosed?

How is calf injury treated?

How can a calf injury be prevented from recurrence?

Rehabilitation

Initial management

Phase 1 Rehabilitation

Range of movement and stretching programme

Strengthening programme

Proprioception balance and co-ordination programme

General mobility and cardiovascular programme


Range of movement and stretching programme






Proprioception balance and co-ordination programme General mobility

and cardiovascular programme






Strengthening and plyometrics programme

Gym programme



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3

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21-22

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29-30

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ANATOMY OF THE CALF MUSCLE

The calf muscle at the back of the shin bone is primarily made up of the large and

powerful gastrocnemius muscle which spans from just above the back of the knee to

the base of the heel bone via the Achilles tendon. Due to this muscle crossing over

both the knee and the ankle it functions to bend the knee and point to foot. These two

key movements of everyday life allow the foot to push off during walking and running

and also provide balance and stability when landing from a jump.

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HOW DO YOU INJURE YOUR

CALF MUSCLE?

A common calf injury is a strain of the gastrocnemius muscle (also known as tennis leg)

which most frequently occurs in sports like running, tennis and skiing but can also be

injured in activities of everyday life such as climbing stairs and running for a bus.

Middle aged athletes with tight calf muscles taking part in physical activity are

commonly affected by this injury, however unlucky everyday circumstances can also be

responsible. It is caused when the gastrocnemius muscle is forcibly lengthened and

overstretched suddenly against its own contraction.

This can happen when the ankle is abruptly dropped off a kerb or step causing a stretch

up the back of the calf or when rapidly pushing off with the foot during sprint

acceleration where the action of the knee straightening suddenly also causes the calf to

become stretched.

Most frequently this injures the point approximately half way down the calf where the

muscle fibres of gastrocnemius meet the Achilles tendon and fail to withstand the

tension which causes it to strain or tear. The degree of this strain is graded from one to

three.

•A mild strain where only a few of the muscle fibres are strained. This can take approximately up to 4 weeks for recovery. Grade 1

•A moderate strain with more muscle fibres torn but not a complete rupture. This can take approximately between 4 and 8 weeks for recovery.

Grade 2

•A severe tear where most of the muscle fibres are torn and can cause a complete rupture of the muscle belly. This can take approximately between 8 and 12 weeks for recovery depending on severity.

Grade 3 4


WHAT ARE THE SYMPTOMS

AND HOW IS IT DIAGNOSED?

A calf strain injury may cause immediate

pain and the sensation of being struck or

kicked on the back of the calf. An audible

“pop” or “snap” may also occur and there

may be bruising or swelling that develops

over the following 24 hours. At the area of

the injury it may be tender and rising up

onto the toes or stretching out the calf

may be painful. Initially walking may be

difficult or too much as weight bearing on

the injured leg can be painful. Continuing

sports training with an untreated minor

strain can cause an increase in pain

leading to a more severe strain or rupture.

A medial practitioner will examine

the injured leg and may ultrasound

the injury site to give a better

indication of the extent and degree

of the strain. They will also want to

rule out any more serious

conditions such as deep vein

thrombosis, acute compartmental

syndrome and cellulitis. Once

diagnosed most commonly a non

surgical conservative management

programme will be prescribed.

Only very rarely in complex

multifactor calf strain injuries with

other contraindications will surgery

be considered.

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HOW IS A CALF INJURY

TREATED?

Depending on the extent of the injury an appropriate exercise rehabilitation programme

will be prescribed and recovery can be supervised by a medical practitioner through

regular appointments. More severe strains will require a longer rehabilitation and

recovery time than more minor strains and will therefore require a more extensive

exercise and treatment programme.

Range of movement and

gentle stretching

Strengthening Proprioception,

balance and co-ordination

General mobility and

cardiovascular

The following must be met before attempting the return to sport:

Pain free equal movement in both legs.

Full strength in the injured leg when compared to the other leg.

Ability to run or sprint without pain or limping.

Ability to cope with sudden changes in direction when sprinting full

speed.

Ability to hop 50 times on injured leg without pain.

It is important when returning to sport that the calf has overcome the risk of re-injury

as commencing regular training prematurely can worsen the injury and cause

permanent damage. Therefore the rehabilitation programme aims to achieve this

goal safely through ensuring strict criteria for the condition of the injured leg are met

first before going back to sport safely. The timescale for this will be individual to each

person and depends on the recovery rate of the calf.

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HOW CAN A CALF INJURY BE

PREVENTED FROM

REOCCURRENCE?

Maintaining the strength and flexibility of the calf muscle will allow it to absorb

greater forces and decrease it susceptibility to being overstretched and reinjured.

Completing a proper warm up with calf stretches before activity will also help

increase the muscle’s ability to perform and overcome re-injury.

Allow several training sessions to gradually build up duration and intensity of sport

before returning to competitions.

Dedicating adequate time for recovery after training sessions or exercise.

Wearing supportive footwear at all times during sport.

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REHABILITATION

Initial Management 48-72 hours

Phase 1 2-7 days

Phase 2 Phase 3

7-14 days Phase 4

Phase 5 14-21 days


Phase 1 3-21 days

Phase 2 3-4 weeks

Phase 3 5-6 weeks

Phase 4 6-7 weeks

Phase 5 8 weeks onwards


Phase 1 3-21 days

Phase 2 3-5 weeks

Phase 3 6-8 weeks

Phase 4 9-11 weeks

Phase 5 12 weeks onwards

Grade 1

Grade 2

Grade 3


This programme is just a guideline and should be done under the supervision of a

trained medical practioner. You may progress more rapidly or slowly through the

programme as guided by your doctor, therapist and your pain levels.

Depending on the extent of your injury whether it is a grade one, two or three with

affect each phase time scale guidelines. These are not exact as it may vary

depending on the individual. Every patient’s rehabilitation can be monitored by the

physiotherapist and doctor. You are advised not to return to full activity too early as

doing this when the injury is not ready can risk re-rupture and further damage.

INITIAL MANAGEMANT

(48 – 72 HOURS)

Goals:

Reduce the inflammation

Control the swelling and pain

•Protect the injury from any further damage through discontinuing sport or demanding physical exercise. Protection

•To aid the healing process rest the leg and reduce the amount of walking until it becomes pain free.

Rest

•To reduce pain and inflammation apply ice to the site of injury for 20 minutes every 2 hours. This can be with an ice pack or pack of frozen peas wrapped in a cloth before applying to the skin.

Ice

•To reduce swelling wear an elasticated bandage support around your calf during the day and remove at night time. As pain diminishes reduce the amount of time wearing the support gradually.

Compression

•Elevate the calf above the height of the hips in resting to reduce the blood flow to the area which in turn reduces the swelling. Elevation

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PHASE 1

Goals:

Reduce pain

Full pain free range of movement

Resume normal walking

Precautions:

Avoid full weight bearing on injured leg until normal walking pattern

is achieved.

•Continue using ice after exercises.

•Continue with compression bandage if support required.

•If allowed take NSAIDS as needed.

•Partial weight bearing walking with crutches and heel wedge if required.

Guidelines for Phase 1

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Remember this programme is just a guideline. You may progress more

rapidly or slowly through the programme as guided by your doctor, therapist

and your pain.



Stretching programme

Calf Stretch

Sit with your injured leg straight out in front of you. Start with the

knee bent slightly (gradually working towards a straight knee) and

loop a towel around the base of your foot holding each end in your

hands. Gently pull the towel toward yourself until you feel a stretch

in your calf. This should be feeling of discomfort and not a sharp

pain.

DO NOT OVERSTRETCH INTO PAIN.

Hold for approximately 5 - 10 seconds and repeat 10 times aiming

to complete 2 – 3 sets each day as comfortable.

Active ankle range of movement

Lying on your back or sitting bend and straighten your ankles

gently as far as you can. Build up to completing this with your

knees straight to also stretch your calf muscle.

Repeat 10 times aiming to complete 2 – 3 sets each day as

comfortable.

Ankle ABC

Moving only the foot and the ankle write the alphabet out

using the big toe as a pencil. Build up to making the

letters as large as possible.

Repeat 5 times and

aim to complete 2 – 3 sets each day as comfortable.

Knee straightening in lying

Lying face down on a bed with your knees and ankles to rest

over the edge of the bed. Relax and allow the weight of your

legs to straighten your knees.

Hold for approximately 5 minutes and

aim to repeat 2 – 3 times a day.

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Knee straightening in sitting

Sitting on a chair pull your toes up, tighten your

thigh muscle and straighten your leg.

Hold for approximately 3 – 5 seconds and

repeat 10 times aiming to complete 2 – sets

each day as comfortable.

Towel toe curls

Sit or stand with your foot on a towel which is laid on a

smooth hard floor. Curl your toes and crumple up the

towel. Keep your heel planted in that position and use

your toes to first pull the towel toward yourself and

then push it away.

Repeat 10 times aiming to complete 2 – 3 sets


Paper pick ups

Scrunch up a few pieces of paper into small balls and

place them on the floor. Using your toes pick up each

paper ball in turn and place it into an area off to the side.

Repeat 10 times aiming to complete 2 – 3 sets


Toe Raises

Sit on a chair with your feet flat on the floor. Keeping your

heel on the floor raise you toes up towards the ceiling as far

as you can.

Hold for approximately 3 – 5 seconds and

repeat 10 times aiming to complete 2 – sets each day as comfortable.

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Proprioception, Balance and

Co-ordination programme

Gym ball sitting balance

Sit on a gym ball which is supported against a wall.

Start off with both feet on the floor and gently shift

your body weight from one side to another while

maintaining your balance. When comfortable lift your

good leg off the floor and allow your injured leg to

keep your balance.

Hold for approximately 10 - 20 seconds and repeat 10

times aiming to complete 2 – sets each day as comfortable.


cardiovascular programme

Walking with crutches

Place the crutches forward with the injured leg and then step through with

the good leg by itself.

Sit to stand with crutches

To sit down remove arms out of the crutches and hold both on one side

and sit. To stand up hold crutches on one side and rise up placing your arms

through the crutches to hold.

Stairs with crutches

Going up stairs first take a step up with your good leg and then

take a step up with your injured leg. Then bring your crutches up

onto the step. Going down stairs first put your crutches down one

step and then take a step down with your injured leg. Then take a

step down onto the same level with your good leg.

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PHASE 2

Criteria for progression to phase 2:

No pain and swelling at rest

Full pain free active range of movement

Normal walking without crutches

Goals:

Full pain free passive range of movement

Normal walking pattern with varying speed and on uneven surfaces

Pain free muscle strengthening

Precautions:

Avoid activity that gives moderate to severe pain

•Progress from partial to full weight bearing in walking as tolerated.

•Use the crutches until normal walking pattern is achieved.

•Use a heel wedge in supportive shoes to reduce the stretch on the calf.


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and your pain.



Stretching programme

Standing calf stretch

Stand with your feet hip width apart and take a step back into a lunge position. With

most of your weight on your front foot gently and gradually take your weight onto

your back foot stretching your heel to the floor. Keep your hips and back foot facing

forwards.


Hold for approximately 20 - 30 seconds and

repeat 10 times aiming to complete 2 – 3 sets


Standing soleus stretch

Stand with your feet hip width apart and take a step back with one foot. Gently take

stretch your heel down to the floor while bending your knee. You will start to feel a

stretch along your Achilles tendon.





Hamstring stretch in lying

Lying on your back lift your leg up toward the ceiling keeping your upper

body on the floor. Hold onto your leg below or above the knee and pull

towards your chest. Try to straighten your leg and to add a further stretch

bring your toes back towards you body.




Quadriceps stretch in lying

Lying face down with a band or towel around your ankle bend your

knee up towards your buttocks and pull the towel with both hands

until you feel a stretch on the front of your thigh.




Knee straightening with chair

Sit with your knee unsupported and your foot on a raise or on a

stool/chair. Allow the weight of your leg to straighten the knee.


Hold for approximately 10mins and repeat 2 times a day.

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Theraband dorsiflexion

Sit on the floor and tie the Theraband to a nearby table leg or pole making

sure it is secure. Put the Theraband around your foot and pull your toes back

towards your body trying to keep your knee straight. Slowly return to the

starting position.

Repeat 10 times aiming to complete 2 – 3 sets each day as comfortable.

Theraband plantar flexion

Sit on the floor and hold both ends of the Theraband. Loop the band around

the base of your foot and try to keep your knee straight. Point your toes away

from yourself resisting this with the band. Slowly return to the starting position.


Theraband ABCs

Sit on the floor and tie the Theraband to a nearby table leg or pole making

sure it is secure. Put the Theraband around your foot. Moving only the foot and

the ankle write the alphabet out using the big toe as a pencil and trying to

keep your knee straight.


Double heel raise

Stand holding onto a chair in front of yourself. Rise up onto your toes with

your weight evenly spread between your feet.

Hold for approximately 3 – 5 seconds and repeat 10 times aiming

to complete 2 – 3 sets each day as comfortable.

Half double leg squat

Stand with your back leaning against a wall and your feet about 30cm from it.

Keeping your quads and hamstrings tight, slowly slide down the wall until

both knees are bent to about 45 degrees or halfway down into a squat. Slowly

straighten your knees and return to the starting position.

Hold for approximately 3 – 5 seconds and repeat 10 times aiming to

complete 2 – 3 sets each day as comfortable.

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Single leg standing

Standing on the one leg lift the other leg of the floor and try to balance. You can do

this in front of a mirror to make sure your knee keeps in line with your big toe.

Exercise Progression.

1. Hold onto a wall with one hand.

2. Fold your arms across your chest.

3. Close 1 or 2 eyes.

4. Place a beanbag on your head.

5 minutes of practice and repeat 2 – 3 times each day as comfortable.

Lunge kneeling

Kneeling on the floor bring one leg in front of you into a lunge position.

Bring your arms out to the side for balance and try to hold this position.

Hold for approximately 20 - 30 seconds and repeat 5 times aiming to


Tandem walking

Walking slowly along a line, placing one foot heel to toe in front of the other,

as if on a tightrope, try to keep to the line.

Variations:

1. High knees

2. Fold your arms across your chest.

3. Tip-toe walking.

4. Close one or two eyes.

5. Walk backwards.

6. Walk sideways.

7. Place obstacles in your path and step over them.

Along a 10m line repeat 10 times aiming to complete 2 – 3 sets each day.

Ball work against wall

Lying on your back place a ball under your foot just above knee

height. Roll the ball under your foot up and down the wall. Progress

this to rolling the ball in circles against the wall.

Repeat 10 times aiming to complete 2 – 3 sets each day.

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Static bike

With the seat at an appropriate height, cycle with no resistance gently to build up

the active movement in your calf. Make sure that your leg is at no point in the

revolution completely straight.

5 – 20 minutes aiming to complete 1 – 2 times each day.

Aqua jogging

This should ideally be carried out in a hydrotherapy pool.

Use an aqua jogger belt in the deep end of the pool. Your feet should

not hit the bottom. Mimic the jogging motion using your arms and legs,

keeping your back upright and straight.

As there is no weighted resistance in the pool it allows you to work at

strengthening your legs and cardiovascular system without risk of injury

reoccurrence from impact. The heat from the pool also has a therapeutic

effect through loosening off tight tissues and encouraging the muscles

To relax.

15 – 20 minutes once a week.

Step ups

Using a step up block place one foot onto the step

and stand up onto this following with your other foot.

Step down with your first foot and follow with your

other foot to return to a standing position. Start of

gently and gradually increase the pace as comfortable.

Repeat 2 – 3 minutes aiming to complete 1 – 2

times each day.


PHASE 3


No pain and swelling with light activity

Full pain free active and passive range of movement

Normal walking pattern with varying speed and on uneven

surfaces

Goals:

Begin moderate to advanced strengthening

Pain free weight bearing strengthening

Increase physical activity level gradually

Precautions:

Avoid activities that gives moderate to severe pain

•Progress to normal activity.

•If able to hop 50 times on injured leg begin to walk or jog as pain allows.


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and your pain.



Toe walking

Stand with the kitchen counter by your side for support if required.

Rise up onto your toes and walk slowly on your toes for the length of

your kitchen counter and back.


Heel walking

Stand with the kitchen counter by your side for support if required.

Bring your toes up into the air and walk slowly on your heels for the

length of your kitchen counter and back.


Wall double squat

Stand with your back leaning against a wall and your feet about

30cm from it. Keeping your quads and hamstrings tight, slowly

slide down the wall until both knees are bent to about 90 degrees

or into a full squat. Slowly straighten your knees and return to the

starting position.

Progress this to doing the squats away from the wall with your

knees and toes in line, your back straight and your bottom tucked

in.

Hold for approximately 3 – 5 seconds and repeat 10 times

aiming to complete 2 – 3 sets each day as comfortable.

Wall squat with heel raise

Stand with your back leaning against a wall and your feet wide apart.

Bend your knees and put your hands on your thighs. Lift both heels off the

floor.

Hold for approximately 3 – 5 seconds and repeat 10 times aiming to


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Range of movement and Stretching programme

Continue with stretching exercises from phase 2. Stretch before and after exercising holding each

stretch for 20 – 30 seconds.




Single leg standing on balance cushion

Stand on one leg on a balance cushion or pillow. Try to keep your

balance. Progress this exercise by crossing your arms across your

chest or closing your eyes.

Hold for approximately 30 seconds and repeat 5 times aiming to


Wobble board balancing

Stand on a wobble board with your hand out to the side for balance.

Practice balancing on it and do not let the sides of the board touch

the floor.

Hold for approximately 2 minutes and repeat 5 times aiming to

complete 1 -2 sets each day as comfortable.

5 point star on balance cushion

Stand on one leg on a pillow or balance cushion. Have 5

points marked out on the floor in a semi-circle at clock

positions 12, 3 and 6 and the points equal distance

between these. While balancing on one leg reach with the

other leg to each of these points without touching the

floor and back to the cushion.

Repeat 10 times aiming to complete 1 -2 sets each day

as comfortable.

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Trampoline jogging

Jog on a trampoline trying to keep raising your knees high. Start of

gentle and increase this gradually to your regular jogging pace.

5 – 10 minutes aiming to complete 1 – 2 times a day.

Single leg squats

Stand on one leg holding onto a chair or a wall for support. Bend you

knee to about 50 degrees with your knee and big toe in line, your back

straight and your bottom tucked in.


comfortable.

Lunges

Stand with an upright posture and your legs hip width apart. Take a

step forward with your one leg and squat down slowly. Push down

through the foot in front to return to the starting position.


comfortable.


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Static bike increased resistance

Start with minimal resistance, 60 – 80 rpm.

Increase this resistance as tolerated.

30 minutes aiming to complete 1 set each day.

• Static Bike – Interval training.

(80 RPM x 4mins : 120 RPM sprints x 1min) x 6

• Static Bike – Single Leg Cycling.

Take one leg out from the pedal and place it on the frame.

Cycle with the leg still in the pedal.

30 minutes aiming to complete 3 sets each week.

Light treadmill walking/ jogging

Start off walking at a comfortable pace on the treadmill and

increase this when warmed up to a fast walk. Once this too is

comfortable start to break into a light jog near the end of repetition.

Try move this point of jogging gradually earlier in the repetition

as it becomes more comfortable.

15 – 20 minutes aiming to complete 2 - 3 sets each week.

Rowing machine

Start off gently and build up the pace gradually while avoiding full

knee extension.

15 – 20 minutes aiming to complete 1 – 2 sets each week.

Swimming

Ease into swimming building up leg kicking work. Don’t start off

too vigorously, begin with gently kicking legs before increasing pace.

20 minutes aiming to complete 2 - 3 sets each week.


PHASE 4


No pain and swelling with advanced activity

Pass score on functional return to sport test

Goals:

Full range of movement, strength, balance and proprioception

Prevention of re-injury

Pain free return to sport

Discharge criteria:

Full unrestricted or limited return to sport with no pain or

swelling

•Return to sport as tolerated gradually building up intensity and duration of training sessions


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and your pain.



Single leg heel raises

Stand holding onto a chair in front of yourself. Stand on

one leg and rise up onto your toes then slowly lower

yourself back down again.

Hold for approximately 3 – 5 seconds and repeat 10

times aiming to complete 2 – 3 sets each day as

comfortable.

Ski jumps

Stand with a line marked on the floor to one side of you.

Squat down and spring up jumping across the line and

let your knees bend underneath you when you land.

Progress this to jumping further from line on both sides.


Leap frog

Stand with a long corridor or sufficient amount of space

in front of yourself. Squat down and spring up jumping as

far as you can in front of yourself. Land letting you knees

bend underneath you to absorb the impact.


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Trampoline single leg standing/ hopping

Stand on one leg on a trampoline keeping your balance with your knee and

toe in line. Progress this to gently hopping on one leg building up the

height of the hop gradually.


Trampoline single leg squats

Standing on a trampoline bend you knee to about 50 degrees with your

knee and big toe in line, your back straight and your bottom tucked in.


Balance cushion lunges

Stand with an upright posture and your legs hip width apart with a balance

cushion or pillow in front of you. Take a step forward onto the cushion with

your one leg and squat down slowly. Try to keep your balance and then

push down through the foot in front to return to the starting position.

Hold for 3 – 5 seconds and repeat 10 times aiming to complete 2 – 3 sets


Single leg standing ball catching

Standing on one foot and keep your balance while bouncing and catching

a ball against the wall. Alternatively throw the ball to and from a partner

while balancing on one foot.

Repeat 30 – 40 times aiming to complete 2 -3 sets each day.

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Grade One Sprint

Slow Accelerate

(6 X 15m) X 2 - slow stop

(10 X 15m) X 2 –slow stop

Grade Two Sprint

Slow Accelerate

(3 X 50m) X 2 – Fast stop


Grade Three Sprint

Fast Accelerate



Session Reps Walk Duration Run Duration Day

1 6 4min 30secs 30secs Mon

2 6 4min 1min Wed

3 6 3min 30secs 1min 30secs Sat

4 6 3min 2min Tues

5 6 2min 30secs 2min 30secs Fri

6 6 2min 3min Mon

7 6 1min 30secs 3min 30secs Wed

8 6 1min 4 min Sat

9 6 30secs 4min 30secs Tues

10 30 minutes continuous running

Once it has been established that you have adequate muscle strength, endurance and

control a running program as the example set out below can be established in

agreement with your physiotherapist and your surgeon.

Progress by building up your pace from ½ to ¾ to full.

Once you are able to run for 30 minutes without pain and can manage 2km’s in

under 12 minutes, the following sprint drills can be commenced, if your sport/activity

or lifestyle requires it.

Starting position should be different for each run.

Remember your running program must not be progressed if you are experiencing pain,

swelling or other symptoms at any level. Remember the program is just a guideline and

not everybody is expected to be at this level. 27


PHASE 5


Normal function during activities of daily living,

Ability to comfortably sit on back of heels,

Uneventful participation in low risk activities (i.e. running,

swimming, golf, low impact aerobics).

Goals:

Single leg hop 95% compared with non-operated leg

95% muscle power and endurance is obtained compared with

opposite limb.

No pain or swelling,

Return to sport.

Precautions:

Avoid returning to sport before you are physically and mentally

ready.

•Return to sports specific training as agreed with your therapist and your surgeon.


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and your pain.


Strengthening and

Plyometrics programme

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Box Jumps

Stand in front of a secured box or platform.

Jump onto box and immediately back down to

same position. Immediately repeat. Jump back

and forth from floor and box as fast as possible,

keeping landings short.

Exercise Variations:

• Jump sideways down to side of box. Jump back onto

box then jump down to the other side of the box. Jump

back onto the box and repeat.

• Jump completely over the box from side to side as fast as

possible.

Exercise Progressions:

• Build up to 2 sets of 30 reps.

• Increase speed.

• Use single leg.

Repeat 5 – 10 times aiming for 2 – 3 sets each day.

Bounding

Stand in front of a short box or platform.

Place one foot on edge of box. Jump up high

and land with opposite foot on edge of box

and other foot on floor. Immediately repeat.

Variations:

• Make the platform higher

• Repeat without a step (skipping on the

spot)


Strengthening and

Plyometrics programme

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Hurdles:

Stand facing collapsible hurdles, barriers or cones

(30-90cm). Squat down and jump over hurdle with feet

together using a double arm swing. Upon landing

immediately jump over next hurdle. Keep landings short.

Hurdles should be collapsible in case it is not cleared.

Progressions:

• Increase height of barrier.

• Increase space between hurdles.

• One legged hopping


Depth Jumps:

Building to 2 sets of 30 reps. Stand on top of a high

box, close to the front edge facing a second box. Jump

from the platform, landing on both feet between the

platform and the box. Jump of the ground as fast as

possible onto the box.

Progression:

• Increase height of platform as

ability improves.

• Use only one leg.


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Gym Programme

Seated Hamstring Curl Machine

Start with the legs nearly fully extended. Move

the heels toward the buttocks as far as possible

and under control, maintaining this control,

slowly extend the knee back to the starting

position.

DON’T ALLOW THE KNEES TO HYPEREXTEND.


• Increase the resistance.

• Use just one leg.

Repeat 15 – 20 times aiming for 2 – 3 sets

each day at low resistance.

Quads Strengthening

Leg Press Machine

Starting with the knee joints at 90 degrees, extend the

legs until straight and then slowly return to the

starting position.


• Increase the resistance.

• Use only one leg.

Repeat 15 – 20 times aiming for 2 – 3 sets

each day at low resistance.


• (8 x 20m) x10

• (8 x 20m) x10

• (8 x 10m) x10

• (8 x 20m) x 10

• (8 x 10m) x 10

• (10 x 20m)

• (20 x 10m)

• (20 x 10m)



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0

4

1

3

2


Using cones, to mark out the circuits, perform the agility drills below.

Six cones are placed 5m apart in a straight line.

The player completes a shuttle run at full pace,

turning alternately to the left and to the right and

sprinting backwards or forwards.

This should be repeated 10 times.

Set 4 cones in a square, each one 10m apart.

Stand in the centre (0) and shuffle (side step)

laterally to the cone on your right (1), shuffle back

to the middle and then shuffle over to the cone on

your left (2) and back to the middle, turn 90o

clockwise and continue shuffling out to the 3rd cone

and back in again to the middle and then onto the 4th,

repeat this circuit 10 times.

Variations: Perform this exercise while doing cariocas (crossed side step

running).

Kicking and bal l work should be int roduced spec i f ic to

the requirements of the spor t .

Return to normal t ra in ing wi th team or coach. Assess

react ion and response.

Begin an easy low grade match against easy opposi t ion.

Assess react ion and response.

Return to fu l l compet i t ion.



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GLASGOW SPORTS A PATIENT SURGERY SERVICE...

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